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| hip fracture | |
|---|---|
| Name | Hip fracture |
| Field | Orthopedics |
| Symptoms | Pain, inability to bear weight |
| Complications | Deep vein thrombosis, pulmonary embolism, infection |
| Onset | Acute |
| Risks | Osteoporosis, falls, age |
| Treatment | Surgery, physiotherapy |
hip fracture A hip fracture is a break in the proximal femur or acetabular region leading to acute pain, immobility and systemic risk in older adults. It commonly follows falls and is managed by orthopaedic surgeons with multidisciplinary care involving geriatricians, anaesthetists, physiotherapists and rehabilitation services. Outcomes depend on fracture location, comorbidities and timeliness of surgical repair, with substantial public health impact in ageing populations.
Patients typically present with severe groin or hip pain, inability to ambulate and external rotation and shortening of the affected limb. Acute presentation often involves altered mental status in patients from Alzheimer's disease care settings, and vital-sign instability may prompt input from Intensive Care Unit teams or consultation with American Geriatrics Society-aligned protocols. Examination and observation in settings such as Emergency Departments are essential to detect occult injuries and concurrent fractures, including pelvic or wrist injuries that may involve transfer to Trauma Centers.
Most hip fractures result from low-energy falls in older adults with underlying bone fragility such as Osteoporosis or secondary causes like long-term glucocorticoid therapy prescribed by specialists in Endocrinology or Rheumatology. High-energy trauma from road traffic collisions involving vehicles regulated by National Highway Traffic Safety Administration or sporting injuries seen in Olympic Games participants can produce similar fractures. Environmental and social contributors include residence in Nursing Homes or post-operative immobility after procedures at tertiary hospitals like Mayo Clinic or Johns Hopkins Hospital.
Diagnosis relies on clinical assessment and imaging: plain radiographs (anteroposterior and lateral views) are first-line in Radiology departments; computed tomography used in complex or occult cases referred from Trauma Centers. Laboratory evaluation by Clinical Laboratory services may include tests for anaemia or infection. Multidisciplinary case review often involves teams from Orthopaedic Surgery and Geriatric Medicine to stratify perioperative risk using tools developed by organisations like the American College of Surgeons.
Fractures are commonly classified by anatomic location: intracapsular femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures, distinctions used in guidelines from bodies such as the National Institute for Health and Care Excellence and classification systems influenced by historical schemes from institutions like Mayo Clinic and Cleveland Clinic. Patterns include displaced versus nondisplaced fractures, and special categories such as pathologic fractures associated with malignancies managed by specialists from American Society of Clinical Oncology.
Acute management follows protocols from World Health Organization-recommended trauma care with pain control, thromboprophylaxis and early surgery when feasible. Surgical options include internal fixation with screws and sliding hip screws, intramedullary nailing, or arthroplasty (hemiarthroplasty or total hip replacement) performed in operating theatres at centres like University College Hospital under anaesthesia by consultants linked to organisations such as the Royal College of Surgeons. Postoperative care encompasses physiotherapy, occupational therapy and secondary prevention measures coordinated with primary care physicians and services influenced by Centers for Disease Control and Prevention guidance on fall prevention.
Complications include venous thromboembolism requiring management informed by American Heart Association guidance, surgical site infection requiring input from Infectious Diseases specialists, implant failure and avascular necrosis after intracapsular fractures addressed in literature from institutions like Harvard Medical School. Mortality risk increases markedly within one year, particularly in patients with comorbidities managed by teams from Cardiology and Pulmonology services; long-term outcomes often involve transitions to long-term care facilities such as Care Homes.
Hip fractures are more common in older populations, with incidence rising in demographic studies from countries like United States and United Kingdom; global burden estimates involve agencies such as the World Health Organization and demographic research centres at University of Oxford. Prevention strategies emphasise osteoporosis screening with bone-density testing promoted by organisations like the International Osteoporosis Foundation, vitamin D and calcium supplementation recommended by public-health authorities, home-safety interventions endorsed by National Institute for Health and Care Excellence, and community programs modelled on initiatives from Centers for Disease Control and Prevention to reduce fall risk. Secondary prevention after an initial fracture includes fracture liaison services implemented in hospitals such as Guy's and St Thomas' NHS Foundation Trust.
Category:Bone fractures